Intest Res.  2018 Oct;16(4):509-521. 10.5217/ir.2018.00074.

Optimizing the multidimensional aspects of the patient-physician relationship in the management of inflammatory bowel disease

Affiliations
  • 1Gastroenterology Unit, Department of Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia. draffendi@ppukm.ukm.edu.my
  • 2Health Psychology Programme, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

Abstract

The patient-physician relationship has a pivotal impact on the inflammatory bowel disease (IBD) outcomes. However, there are many challenges in the patient-physician relationship; lag time in diagnosis which results in frustration and an anchoring bias against the treating gastroenterologist, the widespread availability of medical information on the internet has resulted in patients having their own ideas of treatment, which may be incongruent from the treating physicians' goals resulting in patient physician discordance. Because IBD is an incurable disease, the goal of treatment is to sustain remission. To achieve this, patients may have to go through several lines of treatment. The period of receiving stepping up, top down or even accelerated stepping up medications may result in a lot of frustration and anxiety for the patient and may compromise the patient-physician relationship. IBD patients are also prone to psychological distress that further compromises the patient-physician relationship. Despite numerous published data regarding the medical and surgical treatment options available for IBD, there is a lack of data regarding methods to improve the therapeutic patient-physician relationship. In this review article, we aim to encapsulate the challenges faced in the patient-physician relationship and ways to overcome in for an improved outcome in IBD.

Keyword

Patient-physician relations; Patient reported outcome measures; Communication barriers

MeSH Terms

Anxiety
Bias (Epidemiology)
Communication Barriers
Diagnosis
Frustration
Humans
Inflammatory Bowel Diseases*
Internet

Figure

  • Fig. 1. Amalgamating patients and physicians goals of treatment.

  • Fig. 2. Evaluation of treatment outcomes.


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